Enlarged prostate: symptoms and treatment

March 11th, 2019
A male patient speaks with a physician in this photo.
Men experiencing symptoms of an enlarged prostate are encouraged to check in with their doctor. Photo by Getty Images.

The majority of men over age 50 will deal with an enlarged prostate. But the inconvenient symptoms that come with the condition don’t have to be endured: they can be treated.

Dr. Jamie VanOveren, a urologist in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center, outlines must-knows about enlarged prostate, also called benign prostatic hypertrophy (BPH), below.

Why it happens

The prostate, which is a small, muscular gland that sits near the bladder, naturally gets bigger over the course of a man’s life. But starting as soon as age 50, the increasing growth of the prostate can begin to affect the urinary tract.

Up to 90 percent of men are affected by prostate enlargement in their lifetime. Symptoms can be heightened by other health issues, such as obesity, diabetes, hypertension, low physical activity and alcohol intake.

“The exact cause of BPH is currently unknown,” VanOveren said. “Hormonal changes as a man gets older may play a role, as well as genetics.”

Symptoms

As the prostate grows, it can obstruct urine flow and increase resistance on the bladder.

“That, in turn, creates symptoms of increased urinary frequency, decreased urine flow, straining to void, incomplete bladder emptying and sometimes increased urgency,” VanOveren said.

Impact

Though an enlarged prostate isn’t life-threatening, it can be inconvenient.

“The main concern is often quality of life because the patient tends to go the bathroom frequently,” VanOveren said. “That can affect their sleep and what they do in everyday life.”

If a significantly enlarged prostate goes untreated, issues such as urinary tension, kidney function decline, urinary tract infections and even bladder stones may develop.

Also, keep in mind that symptoms of an enlarged prostate may actually be due to other more serious issues, such as overactive bladder, a urinary tract infection, or even in rare cases prostate cancer.

“There can be other reasons for these symptoms, so a full evaluation is helpful,” VanOveren said.

Treatment

“The primary goal of treatment is to alleviate the symptoms,” VanOveren said. “Also, some treatments can alter the progression of the disease and prevent complications.”

For men with mild symptoms, ‘watchful waiting’ may be the first course of action. “A heart-healthy diet, along with physical activity and exercise, can help with symptoms,” VanOveren said.

As symptoms increase, medications that decrease the prostate’s size, or that relax smooth muscle and reduce obstruction, may be prescribed.

But sometimes, a surgical procedure is needed.

“Typically, we move onto surgical management if medication fails, if the patient’s symptoms are quite bothersome, or if the patient wishes to avoid potential side effects of medication,” VanOveren said.

There are various surgical options, including removing prostate tissue with a scope through the urethra, or the tube that moves urine and semen out of the body; vaporizing prostate tissue with a laser; and using an implant to separate the lobes of the prostate and relieve pressure.

“We make the decision based on a patient’s age, the risks associated with the procedures and the size of the prostate,” VanOveren said.

Most surgical solutions typically last for seven to ten years, but since the prostate continues to grow, there’s a chance further treatment will be needed.

The bottom line: all men experiencing symptoms of an enlarged prostate should check in with their doctor.

“Even though we consider these symptoms to be a normal result of aging, it’s important to be evaluated,” VanOveren said. “One, to rule out other causes, and two, to determine how we can help the patient alleviate bothersome symptoms.”

This article first appeared in the Steamboat Pilot & Today on Feb. 18. 2019.

About the author

Susan Cunningham lives in the Colorado Rocky Mountains with her husband and two daughters. She enjoys science nearly as much as writing: she’s traveled to the bottom of the ocean via submarine to observe life at hydrothermal vents, camped out on an island of birds to study tern behavior, and now spends time in an office writing and analyzing data. She blogs about writing and science at susancunninghambooks.com.